Organization
THE HOUSE OF JUDE CHILDREN SERVICES
Active
Parent organization
THE HOUSE OF JUDE CHILDREN SERVICES
Other names
The House of Jude Behavioral Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE HOUSE OF JUDE CHILDREN SERVICES
Authorized official
EDITH AUGUSTSON NCC, LCPC, LCADC (OWNER)
(410) 705-1331
Entity
Organization
Contact information
Practice address
420 E. 25TH STREET, BALTIMORE, MD 21218
(410) 705-1331
(410) 938-2237
Mailing address
P.O. BOX 5004, MIDDLE RIVER, MD 21220
(410) 705-1331
(410) 938-2237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
NCC-93405
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LC-2284
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411699201
—
MD
05
—
414755300
—
MD
Enumeration date
05/29/2008
Last updated
05/03/2024
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